Multiresistant Shigella species isolated from pediatric patients with acute diarrheal disease.

A total of 57 strains of Shigella (36 S sonnei, 21 S flexneri), isolated from children with acute diarrheal disease who presented for treatment at the Andes University Hospital, Merida, Venezuela, from June 1993 to June 1995, were tested for their susceptibility to trimethoprim, sulfamethoxazole, ampicillin, cefamandole, ceftriaxone, streptomycin, fleroxacin, and nalidixic acid, by the agar dilution method. Twenty-seven strains (75%) of S sonnei and eight strains of S flexneri (38.1%) isolates showed high-level resistance to trimethoprim (MIC90 > 1024 microg/mL), which was also associated with other resistance patterns. The most common resistant phenotype associated with trimethoprim-resistance among S sonnei isolates was sulfamethoxazole-streptomycin (63%); among S flexneri isolates, it was sulfamethoxazole-ampicillin-streptomycin (87.5%). Individual resistance was only observed for ampicillin, mainly in four isolates of S flexneri, and in one isolate of S sonnei. Most Shigella strains were resistant to three or more antimicrobial agents. These results confirmed that multiresistant strains of Shigella are present in Merida, and emphasize the importance to maintain these under surveillance in order to assess local susceptibility patterns and empiric therapy.